The Smarter Messaging Technology Hospitals Should Consider

The messages sent and received in hospitals every day are unlike communications anywhere else. Most are related to patient care and safety. They contain instructions, questions and test results that affect people's lives. Often communications are urgent and require staff to act quickly. In the best scenarios, critical medical events are initiated, communications are sent to the right people, their responses are tracked and any required escalations to alternate staff are managed smoothly and securely.

Healthcare providers are continually tasked with making sure their staff and associates have the very best medical training, diagnostic and treatment technology and information at their command when providing care. It follows that communication technologies like smartphones should be a top focus, due to the high stakes and advanced connectivity they provide. Let's take a look at some of the top advantages smartphone communications can bring to your organization.

1. Smartphone communications systems are HIPAA and HITECH compliant because they provide encryption and security. Patient data is highly sensitive. When transmitted via any type of public network, it becomes electronic protected health information, or ePHI. Hospitals need to take every precaution to protect that information. This includes evaluating messaging systems and protocols in place. Messages sent via email or Short Message Service — better known as text messages — are exposed to the same risks as any public domain communication network — the same systems embraced by people everywhere to ping their friends and family. Do you really want critical healthcare codes and consult requests sent via unsecured technology, winding up in the same inbox as a link to the coolest YouTube video or a reminder to stop for milk on the way home? One thing is certain. Regulatory and government entities don't want this and have established requirements via HIPAA and HITECH standards, stipulating that SMS/texting systems and email are not suitable to handle critical healthcare information. The Joint Commission also stated in November 2011 that texting orders was not acceptable.

Messages sent using smartphones can be protected because today's top healthcare connectivity solutions take advantage of important security best practices. Whether these messages are sent from the secure app on the smartphone, via the Web portal, or an integrated application such as an operator console, Web directory or emergency notification solution, they are encrypted. This prevents phone hackers from intercepting them. Smartphone applications can also automatically remove critical messages after a pre-determined period of time, or after the number of messages reaches a pre-set threshold while leaving personal ones in a separate inbox. Finally, the same industry-best solutions make it possible to delete messages remotely from smartphone devices if the equipment is lost or stolen.

2. Smartphone systems can integrate with your hospital's staff directory or on-call schedules. The last thing anyone needs to worry about when sending a critical communication is trying to find out who's on call or hoping they have the right phone number scribbled on a sticky note. Because paper directories and simple SMS/texting systems exist outside the hospital's IT infrastructure, commonly used phone numbers may be in one person's directory but not another's. And what happens if a physician changes his or her phone number? That information may be given to the hospital's operator group, but is the ER nurse aware of the change? What happens to the patient when the nurse sends a request but doesn't know whether it has gone through or even if it has been received by the correct person? There's too much room for error in the old systems and staff efficiency and patient safety can suffer as a result.

Smartphone communications systems can integrate with your hospital's existing directory database, including on-call schedules. This means sending someone a message is as easy as selecting a name from the contact list, typing the note and hitting 'send.' When integrated with an on-call scheduling system, knowing the person's name is actually irrelevant. It’s possible to just send a message to the specialty or department contact on-call (e.g., the on-call cardiologist) and the scheduling system already has information about who should receive it.

3. Smartphone communications systems can provide full traceability and escalation. Achieving two-way communications in hospitals can be a terribly time-consuming task without help from logic-driven technology. For example, ensuring that all 20 people needed to treat a heart attack patient are available can be a web of phone tag, overhead pages and guessing games. Likewise, many hospitals run into a 'he said, she said' situation when recreating what happened during sentinel events or other crisis situations. Did Dr. Smith get the text message? Did she respond? What did she say? Oftentimes, it's just one person's word against another's when there's no message audit trail. Even for routine communications, such as consult requests or test result notifications, there's often no way to track whether the intended recipient of a message actually received it or what action may have been taken. Meanwhile, patient care could be suffering.

While some SMS/texting systems can track messages sent and delivered, they can't determine whether the recipient acknowledged the notification, or for some reason ignored it. There is also no way to build in automatic escalations of messages in case the primary recipient is unable to respond to the situation in time.

In contrast, leading smartphone communications systems track when a message is sent, delivered and acknowledged, as well as how the recipient responded. Their response can be a simple yes/no acknowledgement or a free-form message. Some smartphone communications systems, in tandem with emergency notification or critical alerting middleware solutions, can take communications to another level and automatically escalate an undelivered message if the user doesn't respond within a specified timeframe. All of this adds up to a robust trail of information that is easy to access should you need to reconstruct the communications around an incident.

4. Smartphone communications systems can ensure priority delivery of messages. With a smartphone messaging application, urgent messages do not compete for priority with messages from friends and family or those flooding the carrier's network, because by the nature of SMS/text messages, they're all handled with equal priority. Messages sent via simple email systems, as is often the case for SMS/texting, can be held up due to the volume of competing messages in the provider's network. This means an important message about critical lab results or an urgent need for a specialist could easily be stuck in the queue behind someone else's "LOL."

5. Smartphone communications systems can isolate critical hospital notifications from those sent by friends and family using a separate inbox. In healthcare, the delineation between important and unimportant communications is black and white. An urgent consult request is critical. A 'happy anniversary' note is not. Smartphone communications solutions focus on getting the user's attention for all critical communications. This means these messages are delivered to a separate, secure inbox reserved for work-related notifications of the highest importance. In addition, these messages can be set to completely take over the recipient's phone to demand attention and response. For patients, this means clinicians are seeing the right messages immediately. For physicians, there's peace of mind in knowing that important communications are highlighted and kept separate from non-critical activities.

6. Smartphone communications systems work over cellular networks and can also take advantage of the security net of Wi-Fi delivery. The ability to communicate with any type of mobile device is only as good as the underlying infrastructure transmitting the messages. Disaster situations such as 9/11, Hurricane Katrina and others remind us that cellular networks can break down or become clogged with too many users. Of course, there are cellular network dead spots to contend with, too. Obviously, a drop in coverage can have a serious impact on patient care if a message is sent but the transmission doesn't reach the recipient.

The power of leading smartphone communications tools is that messages can be delivered not only over cellular networks, but also using Wi-Fi. So if the cellular network drops, your facility’s Wi-Fi network jumps in to keep messages flowing. This failover is automatic. SMS/texting offers no such redundancy.

7. Smartphone communications systems are cost effective. As with any technology, cost always comes into play. Smartphones today require users to purchase a monthly data plan, but SMS/texting plans are not required. With SMS/texting capabilities added, there is either a monthly fee or a per-message fee for someone receiving or sending texts, in addition to the data plan. Depending on whether the hospital or the staff member is footing the bill, this could get even more complicated. When a hospital uses a smartphone communications system for its staff, there is no per-message cost, because the messaging system uses the device's data connection to deliver messages.

Conclusion
Encrypted smartphone communications offer an entirely new level of security, service and traceability for critical healthcare messaging. These solutions keep critical notifications separate from casual conversations to enable clinicians to determine how they should be spending their time. They also help staff close the communications loop with confidence and accountability through a full audit trail. Redundant message delivery networks also mean that more messages get through when time is of the essence.

Smartphones as a key component of an integrated healthcare communications network offer a path to better patient care through a better informed, more efficient staff.

Ms. Bolseth is COO of Amcom Software, where she focuses on growing the company through a combination of organic growth and mergers and acquisitions. She oversees Amcom's operations across professional services, technical support, information technology and human resources. Prior to joining Amcom in December 2008, she served as executive vice president, engineering and product development at Wireless Ronin.

More Articles on Secure Messaging:

ONC Releases Guidelines for Direct Clinical Messaging in HIEs
Text Message Use Among Providers Raise HIPAA Concerns
Secure Texting for Healthcare — the Time Has Come

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